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It is far from an exact science - I ended up at four because it's the highest dose recommended in the product labeling, and even with that I need to stay on Cipro to manage the pouchitis (fortunately quite effectively). I'll confess that I bumped it from two to four when my insurance company behaved inappropriately about it and stopped filling it by mail. I pay the same copay for a month's supply regardless of the dose, so increasing the dose didn't cost me anything.

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